BONES DISORDERS DIETARY Rickets Osteoporosis Osteomalacia 1. Kidney disease 2. Insufficient Vit-D in diet 3.

Mal-absorption of Vit-D from gut BONE METABOLISM ACTIVITY Exercise thought to promote release growth factors and hormones HORMONES ENDOCRINE Osteopenia & Low oestrogen level Hyper-thyroidism High aldosterone levels high cortisol levels

intestine osteoclasts blood calcium osteoblasts +

osteoblasts + osteoclasts

PHARMACOLOGY CALCITONIN ESTROGENS NEW DRUGS a) from salmon a) prevention of osteoa) Selective Oestrogen b) used to treat malignant porosis in early menoReceptor Modulators hyper-calcaemia and pausal women (SMRS) sever Pagets disease b) side effects b) Tamoxifen, raloxifene c) must be injected short term long term d) side effects: breast tenderness gall stones diarrhea vaginal bleeding breast cancer nausea, acid reflux headaches endometrial cancer hypocalcaemia abdominal bloating _________________________________________________________________________ ______ DRUGS USED TO TREAT RA NSADIs Inhibits COX1 and COX2 GLUCOCORTICOI DS Mimic native cortisol by systemic or local injection GOLD SALTS Inhibits gene expressio n+ reaction on proteins of Immune Response ANTI MALARIAL S Stabilize lysosome s membran es, inhibiting phagocyti c activity of white blood cells IMMUNO SUPPRES SANTS Inhibits the action of Thelper cells by suppressi ng the productio n of lymphoki nes SULPHAS ALAZINE Also used for AS, HLA-B27 related arthropati es act making antigen focal points

PARATHYROID HORMONE Increases blood calcium by blood calcium negative feedback feedback blood calcium

CALCITONIN Decreases by negative

blood calcium

Parathyroid glands produce Thyroid Gland produces PTH Calcitonin release of calcium from release of Bone bone absorption of calcium from calcium from Kidneys absorption of calcium from calcium inhibits calcium from the excretion of kidneys blood

NSAIDs treat the symptom s reducing swelling and pain; DMARDs tackle the causes modyfing or stopping its progress used as LAST resort (usually in hospitals)

1.Suppres s prostagla ndin formation , (inflamma tory mediated ) 2. Inhibit Tcytotoxic (killer) cell mobility

Auranofi n = side effects: death, mouth ulcers, skin rashes, blood disorders, jaundice, hair loss, periphera l neuritis

Choloroq uine = side effects: retinal damage (blindnes s), headache s, GI disturban ces, convulsio ns, mental disorders

Azathiop rine = side effects: nausea, vomiting, GI disturban ces, liver damage

Side effects: nausea, vomiting, loss of appetite, bleeding, bruising